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Impact of airway obstruction on lung function in very preterm infants at term

Anne Hilgendorff1, Irwin Reiss, Ludwig Gortner

  • 1Department of Pediatrics and Neonatology, University of Giessen and Marburg, Germany. anne.hilgendorff@med.uni-muenchen.de

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|October 8, 2008
PubMed

Insights

Obstructive ventilatory disorders significantly impact lung function in very preterm infants. Bronchodilation revealed underlying issues, highlighting the importance of body plethysmography for diagnosis before discharge.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Respiratory Physiology

Background:

  • Pulmonary complications significantly influence morbidity and mortality in preterm infants.
  • Obstructive ventilatory disorders are a key concern in very preterm infants with a history of respiratory distress syndrome and/or bronchopulmonary dysplasia.

Purpose of the Study:

  • To investigate the impact of obstructive ventilatory disorders on lung function in very preterm infants.
  • To assess changes in lung function before and after bronchodilation using body plethysmography.

Main Methods:

  • Lung function was assessed in 27 preterm infants (gestational age ≤31 weeks) at a median postmenstrual age of 38 weeks.
  • Measurements included effective airway resistance (Raw), specific conductance (SGaw), functional residual capacity (FRCbox), and total respiratory system compliance (Crs).
  • Assessments were performed before and after inhaled salbutamol via nebulization using MasterScreen Baby Body plethysmography.

Main Results:

  • Median effective airway resistance (Raw) was initially normal but decreased significantly after salbutamol administration.
  • Specific conductance (SGaw) showed corresponding changes.
  • Functional residual capacity (FRCbox) was reduced compared to healthy term newborns and further decreased after bronchodilation; Crs remained unchanged.

Conclusions:

  • This study quantifies the significant impact of obstructive ventilatory disorders on lung function in very preterm infants at term.
  • Overinflation can mask reduced lung volume in these infants.
  • Body plethysmography is a valuable diagnostic tool for quantifying ventilation disorders and guiding therapy in preterm infants before hospital discharge.
Abstract

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